Fonsecaea monophora所致着色芽生菌病  

Chromoblastomycosis caused by Fonsecaea monophora: The first case reported in the Yunnan-Guizhou Plateau

作　　者：秦琴[1] 晏文[2] 鲁东平[3] 孙东升 贾常莎[2] 陈雷刚[2] 谌宏运[2] 张信江[2] 

机构地区：[1]深圳市宝安区人民医院皮肤科,广东深圳518101 [2]遵义医学院附属医院皮肤科,贵州遵义563000 [3]深圳市宝安区慢性病防治院皮肤科,广东深圳518133

出　　处：《临床皮肤科杂志》2017年第12期864-867,共4页Journal of Clinical Dermatology

基　　金：贵州省卫生计划生育委员会(gzwkj2012-1-022);深圳市宝安区科技计划基金(2014043)资助项目

摘　　要：报告1例云贵高原地区由Fonsecaea monophora所致着色芽生菌病。患者男,38岁,农民。左小腿异物刺伤后皮肤出现丘疹、溃疡、增生伴疼痒8年。皮肤科检查:左小腿踝部至膝关节之间见大片界限清楚的红褐色斑块,边缘隆起,表面凹凸不平,呈肉芽肿样或疣状增生,并有溃疡、瘢痕形成或黄色厚痂覆盖,痂皮下有脓性或血性分泌物渗出,味腥臭。皮损组织病理:表皮假上皮瘤样增生,可见慢性肉芽肿样改变,真皮内大量中性粒细胞、淋巴细胞、浆细胞和组织细胞混合浸润,形成微脓肿,PAS染色其内可见成簇棕色厚壁孢子。取真菌培养菌落聚合酶链反应(PCR)扩增及r DNA ITS区测序鉴定为Fonsecaea monophora。诊断:Fonsecaea monophora所致着色芽生菌病。A case of chromoblastomycosis caused by Fonsecaea monophora is reported. A 38-year-old farmer from Tongren city of the Guizhou province had had painful erythemas, ulcerations and papules on the left lower leg since it was injured 8 years ago. Physical examination showed uneven, demarcated red brown plaque with elevated boundaries on the left lower leg. Lesion appeared granulomatous or verrucous hyperplasia. The plaque was covered with ulcerations, scars, yellow crusts, puru- lent or bloody secretions with fish odor. Histopathological examination showed pseudoepitheliomatous hyperplasia and chronic granulomatous changes in the epidermis. In addition to microabscesses, infiltrations of neutrophils, lymphocytes, plasma cells and histiocytes were present in the dermis. PAS staining revealed brown thick-walled spores in the lesional tissue. Fryecaea monophora was identified by PCR amplification and rDNA ITS sequencing. Diagnosis of chromoblastomycosis caused by Frye- caea monophora was made.

关 键 词：Fonsecaea monophora 着色芽生菌病 RDNA ITS序列 

分 类 号：R756.6[医药卫生—皮肤病学与性病学]